Peer-to-Peer Sessions

Developing Paired
LeadershipPaul Sternberg, Jr., M.D.,
G.W. Hale Professor & Chair, Vanderbilt Eye
Institute, Assoc. Dean for Clinical Affairs,
Vanderbilt School of
Medicine, Asst. Vice Chancellor for Adult
Health Affairs; and Brian R.
Carlson, M.H.S.A., M.B.A., Department
Administrator and PCC Director,
Vanderbilt Eye Institute, Vanderbilt Cosmetic
& Plastic Surgery;
Vanderbilt University Medical Center and
Vanderbilt Medical Group
Using actual business
scenarios and examples, the presenters will lay
out the process by which they were able to
develop a paired leadership
model that has moved Vanderbilt Eye Institute
forward on all relevant
metrics for success.Upon completion
of this activity, participants should be able to
describe the concept of paired leadership;
explain how to develop a
paired leadership model including the
personal attributes it takes to
have paired leadership; and describe a
framework for decision making and
accountability in paired leadership.

Medical Group Transition:
Steps to SuccessScott Griffin, Former
President and Chief Executive Officer, Reading
Hospital Medical Group; and Michael Soisson,
Healthcare Practice Leader, Pinstripe
Healthcare
Given the current changes
in healthcare market, many physicians and
medical groups are moving towards an
employment or acquisition strategy
within larger hospitals or healthcare
systems. This presentation
will present a case study of how the
physicians in the Reading,
Pennsylvania area transitioned their
practices to a larger,
multispecialty group practice that is owned
and operated by the Reading
Hospital and Medical Center.Upon
completion of this activity, participants should be able to
describe key factors that have proven
successful in the transition of a
number of physician practices into a
hospital-based group.

Advanced HIE
Technologies Improve Medical Adherence and Quality
ManagementTom Deas Jr.,
M.D., Board Member, North Texas Specialty
Physicians
Discover how a physician organization
implemented the three essential
HIE technology elements to improve care
coordination and quality
management through clinical decision support,
advanced quality measures,
and EMR interoperability and to pave the way
to becoming an accountable
care organization.Upon completion of
this activity, participants should be able to
describe the three essential technology
elements for quality and medical
adherence management; delineate examples of a
CCR document, data from a
secure web portal, and quality reports (e.g.,
PQRI, HEDIS) produced by
the HIE, highlighting the advantages of
reports from the interoperable
HIE comprehensive EHR platform; discuss how
the independent practicing
physicians use the HIE's clinical decision
support quality application
at the point of care to track care quality
measures which meet the EHR
meaningful use criteria; and determine
strategies to leverage the HIE
and lessons learned into its Accountable Care
Organization design and
development.

The Physician Group
Practice Transitions Demonstration ProgramFrederick J. Bloom Jr., M.D., M.M.M.,
Assistant Chief Quality
Officer, Geisinger Health System
The
Physician Group Practice (PGP) demonstration program
successfully
showed CMS that large group practices could
improve the quality of care
provided and reduce the overall cost of care.
When demonstration ended,
the 10 participating groups negotiated a
three-year PGP Transitions
demonstration to provide them an incentive to
continue improving the
quality and efficiency of care provided to
Medicare patients while
transitioning to Accountable Care
Organizations in the Medicare Shared
Saving program.Upon completion of
this activity, participants should be able to
describe the evolution of the CMS Physician
Group Practice demonstration
program into the PGP Transitions
demonstration program; identify design
aspects of the PGP demonstration program that
have been corrected in the
PGP Transitions program; explain the
significance of different models of
patient attribution, risk adjustment, and
savings corridor calculation;
and identify the quality criteria used in the
PGP Transitions program
and the additional bonus offered for
reporting as bundled measures and
reporting a patient experience
measure.

Chronic Disease Toolkits:
Spreading Quality Outcomes SimplySteve Sarette, Process Improvement
Specialist; and Gerald H. Angoff,
M.D., FACC, M.B.A., Chair of the Quality and
Outcomes Improvement
Committee , Dartmouth-Hitchcock
Clinic
Dartmouth-Hitchcock Clinic's toolkit to
maximize outcomes for chronic
disease management uses common business
process improvement tools and
can be replicated for multiple chronic
disease conditions. The
presentation will show how to use such
toolkits to spread best practice
across the Medical Home departments with the
support of trained coaches
and minimal training for existing clinic
staff.
Upon completion of this activity, participants
should be able to
describe the DHC approach to chronic disease
management and the value of
the toolkit format for quality
improvement.

CMS Meaningful Use and
BeyondAman Bhasin,
Chief Information Officer, Orlando Internal
Medicine, and Steve Vicker,
Chief Information Officer, Manhattan
Physicians Group
Successful adoption of the CMS
meaningful use measures can
significantly affect an organization's
financial viability. This session
will explore the measures and how to
formulate a robust quality program
that meets the criteria while remaining
aligned with organizational
priorities and goals.Upon completion
of this activity, participants should be able to
discuss CMS Meaningful Use, define the stages
of adoption and appreciate
the importance of group participation;
identify opportunities to align
CMS Meaningful Use program initiatives with
other pay of performance
initiatives and well as their own
organizational goals; describe the
value of defining quality metrics in the
early stages of EHR
implementation; and build an EHR based
quality program using Meaningful
Use measures via a successful collaboration
between their clinical
leaders, quality and information
technology.

Developing Accountable
Care NetworksMichael Boguszewski,
M.B.A., Director of Strategy and Growth, Park
Nicollet Health Services; and Ross A.
Armstrong, M.S.H.A., M.B.A.,
Manager, ECG Management
Consultants
Hospitals and physician groups now
realize they must develop
integrated networks of accountable care that
span geographies and the
service continuum to significantly enhance
the quality and decrease the
cost of healthcare in the U.S. The speakers
will address options and
priorities for managing the complicated
pathway to accountable care
network formation, as well as share the
experiences of Park Nicollet
related to its own "work in progress"
development.Upon completion of this activity,
participants should be able to
delineate the necessary components required
to develop a network of
accountable care.

Creating and Implementing
a Physician Compensation Plan in the
Patient-Centered Medical
HomeChristine Griger, M.D., M.B.A.,
President, Affinity Medical Group;
and Ed Scanlan, M.D., Medical
Director, Network Health Plan
This interactive discussion describes the
steps Affinity Medical Group
took to transform a productivity-based
primary care physician
compensation plan into an innovative hybrid
model that takes physicians
off the proverbial treadmill and directs
practice pattern changes by
aligning compensation with organizational and
medical home goals
featuring productivity, cost, access,
quality, satisfaction, panel size,
and off-line work.Upon completion of
this activity, participants should be able to
describe how to create and implement a
physician compensation plan that
aligns with organizational goals and with the
objectives of the
patient-centered medical home; discuss the
process of engaging
physicians within an integrated healthcare
organization in the process
of developing their compensation plan within
these parameters; and
explain how a properly constructed
compensation plan can help position
an integrated delivery system to accept risk
as an accountable care
organization.

Value of Detailed
Comparative Data in Understanding Variation
in Process of Care and
Designing Strategies to Improve Population
Health and Optimize Resource
UseJohn Cuddeback, M.D.,
Ph.D., Chief Medical
Informatics Officer, Anceta; A.G.
Breitenstein, J.D., M.P.H., Vice
President, Provider Markets, and Mary Lantin,
M.P.H., Director of
Operations, Humedica
Variation from
evidence-based guidelines
reveals only part of the opportunity that
medical groups have to improve
care. Guidelines are of little value in
prioritizing potential
interventions for high-risk, high-cost
patient populations, who fall
outside the scope of typical guidelines. The
Anceta collaborative data
warehouse, developed in partnership with
Humedica, contains longitudinal
EHR, e-prescribing, and administrative data
on more than 10 million
patients of participating medical groups,
normalized and mapped to
provide meaningful comparisons of care
process and outcomes at a medical
group and clinician level. Through direct
access to detailed internal
and comparative data and the Anceta
collaboratives, medical groups are
learning how other groups are treating
patients with similar
combinations of clinical comorbidities and
sociodemographic factors,
their relative resource use, and the outcomes
they're achieving. The
presenters will provide examples of Anceta
participants' identification
of under-treated, high-risk patient
populations and variation in care
approaches, outcomes, and cost using the
detailed comparative data.Upon completion of this activity,
participants will be able to
explain how Anceta and Humedica enable AMGA
members to under­stand
variation in practice and its impact on
quality and cost; and to discuss
the use of comparative data for measuring
clinical performance and
identifying high-risk patients with diabetes
and other chronic
conditions.

Being Accountable for
Healthcare Delivery in Central OhioThomas D. Thompson, M.B.A., Vice
President of Business Development;
and James Dougherty, M.D., Chief
Medical Officer, The Medical Group of
Ohio (MGO)
This presentation will
describe the new and necessary structure that
MGO put in place that resulted in committed
leadership from the
physicians and the health system to
accomplish clinical integration and
successful contracting with two of the four
largest payers in Central
Ohio. Presenters will share
demonstrated results and interactions
with the commercial payers, discuss the
necessary investment, processes,
and tools, and explore how this effort
positions the group in pursuit of
being an ACO.Upon completion of this
activity, participants should be able to
describe how an IPA can be instrumental in
developing a clinically
integrated system of care delivery including
independent physicians and
a hospital system; discuss how using results
from pilot programs that
includes a pay for quality component, becomes
a model adaptable to the
commercial payers; explain how the IPA has
been able to demonstrate the
improvement of quality and value of
healthcare services to the
purchasers in Central Ohio; and explain how a
clinically integrated
network and related infrastructure can be a
spring board to an
Accountable Care Organization.

An Integrated Framework
for Reducing Health DisparitiesBeth Averbeck, M.D., Associate Medical
Director, Primary Care, HealthPartners Medical
Group
Disparities are evident in nearly all facets of
our healthcare
system. With technological advances,
leaders have the opportunity
to focus on populations that persistently
experience lower levels of
satisfaction and worse health outcomes.
Learn how to utilize a
data-driven approach for reducing disparities
and improving global
performance.Upon completion of this
activity, participants should be able to
design a data driven approach for achieving
equity; articulate the
advantages of integrating disparities
reduction goals into annual
planning processes and accountability
mechanisms; develop plans for
involving diverse communities in designing
tests of change; discuss how
technology can support systematic care
customization; and describe why
health care leaders should consider
disparities reduction as a key part
of an organization's strategic
imperative.

Ready? Triple Aim!
Align! Taking Steps Toward an Accountable
Care OrganizationScott
Hines, M.D., Endocrinologist, and Jonathan Nasser, M.D.,
Internist and Pediatrician, Crystal Run
Health Care
This
interactive presentation will outline the
processes employed to align
physicians to an accountable care model of
healthcare delivery.
Application of IHI's Triple Aim will be
demonstrated, with specific
examples of changing physician evaluation,
defining quality measures,
improving patient experience, creating local
best practice standards,
and measuring and reducing cost.Upon
completion of this activity, participants should be able to
describe the tenets of the triple aim and
understand their applicability
to the pursuit of accountable care; describe
how these tenets can be
applied to a physician performance matrix in
an effort to align
physicians toward a goal of accountability;
explain a process for
developing department specific quality
measure in both primary and
specialty care; and articulate how creating
practice standards can be
used to standardize work, analyze utilization
and control cost of care.

Aligning with Physicians
to Improve Care and Create ValueMarty Manning, President, and Mark
Shields, Senior Medical Director,
Advocate Physician Partners
The
presentation focuses on an integrated model of care developed
by
Advocate Physician Partners that aligns
physicians, patients, and
payers. It will explore how
infrastructure, technology, financial
models, evidence-based medicine, and other
measures improve clinical
outcomes.Upon completion of this
activity, participants should be able to
describe a governance structure and physician
alignment model that
supports cultural change for thousands of
independent and employed
physicians; develop a model of care that
integrates all stakeholders,
physicians, patients and payers, with a
common goal to improve the
quality and value of care; articulate the
impact of information
technology in streamlining the care delivery
process and uniting
physicians; design an infrastructure with
proven outcomes that impacts
clinical care, efficiency, medical &
technological infrastructure,
patient safety and patient experience;
establish a financial funding
model which includes a pay-for-performance
incentive, aligning
physicians and improving clinical outcomes;
and advance their existing
infrastructure by incorporating Medical Home
and Accountable Care
guidelines.